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Chronic daily headaches in children.

Andrew D Hershey1, Marielle A Kabbouche, Scott W Powers

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Area of Science:

  • Neurology
  • Pediatrics
  • Headache Medicine

Background:

  • Chronic daily headache (CDH) is a growing concern in pediatric neurology.
  • Prevalence in children is not well-established, though it appears lower than the estimated 4% in adults.
  • CDH is defined as experiencing headaches on more than 15 days per month.

Purpose of the Study:

  • To review the diagnostic criteria and management of chronic daily headache in pediatric populations.
  • To highlight the complexities in diagnosing CDH, including medication overuse headache.
  • To emphasize the need for a comprehensive evaluation and treatment strategy.

Main Methods:

  • Review of International Classification of Headache Disorders (ICHD-II) criteria.
  • Contrast with Silberstein-Lipton criteria for CDH.
  • Discussion of diagnostic challenges and treatment modalities.

Main Results:

  • CDH diagnosis is complicated by medication overuse, requiring resolution before definitive diagnosis.
  • Pediatric CDH often exhibits migraine features but may not fully meet diagnostic criteria.
  • Secondary causes of headache must be ruled out through thorough history and physical examination.

Conclusions:

  • A multidisciplinary approach is essential for managing pediatric CDH.
  • Treatment includes acute care (avoiding medication overuse), preventive strategies, and biobehavioral therapy.
  • Effective management aims to reduce headache frequency and improve long-term outcomes.